micro 5 Flashcards

(46 cards)

1
Q

charact of mycobacteria

A

aerobic
non spore
immotile
gram positive

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2
Q

what does mycobacteria have in its cell wall

A

hydrophobic material (mycolic acid)

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3
Q

hydrophobicity gives mycobacteria what charac

A

slow grower
chronic disease
resist drugs
resist decolorization

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4
Q

mycobacteria classified into

A

m.tb complex
m.leprae
non tuberculous mycobacteria (NTM) : stypical mycobacteria

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5
Q

MAC : m.avium and m.intracellular what group

A

type 3 slow grower

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6
Q

classification of NTM

A

Slow grower and rapid grower on lowenstein jensen (LJ)

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7
Q

slow grower classified according to ability to produce yellow carotenoid pigment what are the types

A

type 1 : photochromogens (only in light)
type 2 : scotochromogens (dark and light)
type 3 : nonchromogens

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8
Q

progression of TB depend on

A

balance between virulence and immune system

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9
Q

virulence factors of mycobacteria

A

catabolism of oxidants

prevent phagolysosome fusion

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10
Q

immune system factors against TB

A

IL-12 : TH1 diffrentiation that secrete interferon gamma
IFN gamma: enhance phagolysosome fusion
TNF alpha: reactive nitrogen species (RNS)

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11
Q

In response to TB infection what type of sensitivity develops

A

delayed type HS (DTH)
epitheloid cells that enhance secreting
langhans giant cells enhanced phagocytic activity

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12
Q

two possible outcomes when bacilli attacked by immune system

A

immediate eradication

development of specific immunity

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13
Q

immediate eradication what happens

A

bacteria eliminated by innate immune system (macrophages)

body not sensitized to bacteria

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14
Q

specific immunity what happens

A

DTH in regional LN (ghon focus)

ghon focus and LN its called ghon complex or primary complex this is called primary TB

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15
Q

Outcomes of primary tb

A

progressive primary tb

latent tb

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16
Q

progressive primary tb

A

host immune response is weak leading to active disease
pneumonia like ( middle and lower lobe with LAP hilar and pleural effusion)
segmental tb
hemorragic
obstruction
bacteremia

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17
Q

latent tb

A

host immune response is strong to keep microbe in dormant

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18
Q

when there is a resume in microbial activity what is it called

A

post primary or secondary

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19
Q

secondary tb

A

reactivation of old strain or reinfection with new one

20
Q

features of secondary tb / open tb

A

in apex
fibrosis and cavitation
aspergilloma

21
Q

distant spread in secondary TB occurs through

A

tracheobronchial tree
pulmonary vein : systemic miliary tb
pulmonary artery ; ;localized pulmonary miliary tb
lymphatic system ; diffuse pulmonary miliary tb

22
Q

immunodiagnosis of tb

A

tuberculin skin test

in vitro interferon gamma assay (IGRA) : QUANTIFERON TB (GOLD)

23
Q

Microscopy for tb

A

carbol fuchsin stain : zn and kinyoun under brightfield

auramine rhodamine ; florescent microscope

24
Q

PCR for tb

A

increased sensitivity and specificity

predicts MDR

25
culture of tb
early morning sample for 3 consecutive days decontamination by an alkali (2% NaOH) medium used : LJ medium or middlebrook and needs 4 weeks liquid medium needs 2 weeks and for MODS
26
FIRST LINE TB DRUG
Isoniazid rifampin ethambutol pyrazinamide
27
second line tb
p-aminosalicylic acid cycloserine aminoglycoside capreomycin
28
MDR TB
To isoniazid and rifampin
29
XDR TB
MDR TB with resistance to one injectable second line and 1 floroquinolone
30
treatment course phases
initiation and continuation
31
immunoprophylaxis using what
BCG (m.bovis)
32
immunoprophylaxis decrease risk of
tb meningitis and disseminated disease in children | pulmonary TB in adults
33
BCG vaccine contraindicated in
immunocompromised
34
MAC causes
disseminated disease in AIDS
35
how is mac transmitted
ingestion
36
mac causes what in immunocompetent
tb like cavitation in middle or elderly man with history of lun disease bronchiectasis, middle lobe or lingular infiltrate in non smoker elderly women solitary pulmonary nodule
37
chemoprophylaxis for mac in HIV patients with CD4 below 50 by
macrolide
38
rapidly growing mycobacteria (RGM) organisms
M. fortuitum M.chelonae M.abscessus
39
RGM can be found on body surfaces without causing disease but can also cause chronic diseases with multiple recurrences
yes
40
RGM can acuse
pulmonary infection without cavitation and multilobar or iatrogenic or opportunistic infec
41
RGM treated by
clarithromycin
42
what drug is an arabinogalactan syn inhib
ethambutol
43
what drug is mycolic acid syn inhib
isoniazid | ethionamide and prothionamide
44
what is the MOA of pyrazinamide
distrubts cell emmbrane eneergy function
45
what is the MOA of rifampin
inhibitor on DNA dependent RNA pol
46
what is a peptidoglycan syn inhib
cycloserine